John Buen v. HHS - Influenza, sudden sensorineural hearing loss (2025)

John Buen, a 50-year-old adult, received an influenza vaccine on September 15, 2019. Six days later, on September 21, 2019, he began experiencing tinnitus in his left ear, followed by sudden hearing loss in his left ear on September 22, 2019, and subsequently vertigo.

He was diagnosed with sudden sensorineural hearing loss (SSNHL) in his left ear. Mr.

Buen filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging the flu vaccine caused his SSNHL. Respondent argued against compensation, stating the case was not appropriate for compensation under the Vaccine Act.

The court considered the case as an off-Table claim, requiring Mr. Buen to prove causation.

Mr. Buen presented expert testimony from Dr.

Edwin Monsell, who proposed a seven-step mechanism by which the flu vaccine could cause SSNHL through inflammatory and microvascular events leading to cochlear ischemia. Respondent presented expert testimony from Dr.

Jay T. Rubinstein, who opined that Mr.

Buen's SSNHL was more likely caused by a viral infection or an undiagnosed acoustic neuroma, and that a systemic vaccine reaction would typically cause bilateral, not unilateral, hearing loss. The court found that Mr.

Buen failed to provide a sound and reliable medical theory connecting the flu vaccine to his SSNHL, noting that the pathogenesis of SSNHL is largely unknown and that Dr. Monsell's proposed mechanism was not sufficiently supported by the cited literature.

The court also found that the evidence did not support a logical sequence of cause and effect, noting that Mr. Buen's hearing loss did not show a strong response to steroid treatment and that other potential causes, such as viral illness or acoustic neuroma, were considered.

Although a temporal relationship was established, the court ultimately denied Mr. Buen's petition, finding he failed to meet his burden of proof for causation.

Therefore, the petition was dismissed.